IARC scientific publications最新文献

The Singapore cancer registry is a national registry established in 1968. Cancer registration is done by passive methods. The registry contributed survival data on 45 cancer sites or types registered during 1993-1997. Data on 34 cancers registered during 1968-1997 were utilized for survival trend by period and cohort approaches. Follow-up was done by passive methods, with median follow-up ranging between 2-72 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged between 27-100%; death certificates only (DCOs) comprised 0-7%; 76-100% of total registered cases were included for the survival analysis. The top-ranking cancers on 5-year age-standardized relative survival rates were nonmelanoma skin (96%), thyroid (90%), testis (88%), corpus uteri (77%), breast (74%), Hodgkin lymphoma (73%) and penis (70%). Five-year relative survival by age group showed either a decreasing trend with increasing age groups or was fluctuating. Localized stage of disease ranged between 18-65% for various cancers and survival decreased with increasing extent of disease. Period survival closely predicted survival experience of cancers diagnosed in that period, and an increasing trend in period survival over different periods indicated an improved prognosis for cancers diagnosed in those calendar periods.

The Madras metropolitan tumour registry was established in 1981, and registration of incident cancer cases is entirely done by active method. Data on survival for 20 cancer sites or types registered during 1990-1999 are reported. Follow-up has been carried out predominantly by active methods with a median follow-up time ranging between 2-28 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 45-100%; death certificates only (DCOs) comprised 0-5%; 68-95% of total registered cases were included for survival analysis. Complete follow-up at five years ranged between 83-96%. The 5-year age-standardized relative survival rates for common cancers were cervix (60%), breast (47%), stomach (8%), oesophagus (9%), lung (6%) and mouth (36%). The 5-year relative survival by age group portrayed either an inverse relationship or fluctuated. A majority of cases were diagnosed with regional spread of disease, and survival decreased with increasing extent of disease. The absolute difference in 5-year relative survival of most cancers diagnosed in 1984-1989 and1990-1999 ranged between 2-3%, with lesser survival in the latest period in most instances.

The Bombay cancer registry is the second oldest population-based cancer registry in Asia, and the first of its kind in India. It was established in 1963, and registration of cases is done by active methods. Data on survival from 28 cancer sites or types registered during 1992-1999 are reported. Follow-up has been carried out predominantly by active methods, with median follow-up ranging between 1-51 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 41-100%; death certificates only (DCOs) comprised 0-15%; 84-99% of total registered cases were included for survival analysis. Complete follow-up at five years ranged from 85-92% for different cancers. The 5-year age-standardized relative survival rates for common cancers were breast (48%), cervix (44%), lung (11%), oesophagus (14%), oral cavity (35%) and non-Hodgkin lymphoma (34%). The 5-year relative survival by age group portrayed either an inverse relationship or was fluctuating. Cases with a regional spread of disease were the highest for cancers of the tongue, oral cavity, larynx and cervix; survival decreased with the increasing extent of disease for all cancers studied.

The population-based cancer registry in Manila, Philippines, called the Philippine Cancer Society-Manila Cancer Registry, was established in 1983. Cancer registration is pursued by active methods. The registry contributed survival data on a random sample of total incident cancers of breast (500), cervix (500), colon and rectum (300) registered in 1994-1995. Follow-up has been carried out by passive and active methods, with median follow-up ranging between 15-33 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 78-88%; 74-83% of the total submitted cases were included for survival analysis. Complete follow-up at five years was available in 75-82% of cases. Five-year age-standardized relative survival rates was the highest for cancer of the breast (52%) followed by colon (49%), cervix (36%) and rectum (31%). Five-year relative survival by age group did not display any pattern or trend and was fluctuating. A decreasing survival with increasing extent of disease was noted for all cancers.

Thirty-one registries in 17 countries submitted data for systematic and centralized scrutiny. Data on 564 606 cases of different cancers ranging 1-56 sites/types from 27 registries in 14 low-/medium-resource countries in Eastern and Western Africa, the Caribbean, Central America and four regions of Asia, registered during 1990-2001 (period varying for individual registries) were reported. The database for this survival study comprised data that were classified as mandatory and optional. Mandatory variables provided by all registries included case-ID, age at diagnosis, sex, incidence date, most valid basis of diagnosis, cancer site/type (ICD-10 codes C00-96), vital status at follow-up and corresponding date. Clinical extent of disease was prominent among the optional variables provided by 17 registries and analysed. The grouping of cancer sites for analysis was based on standard norms, and only categories with at least 25 cases were reported. Cases registered based on a death certificate only, cases lacking any follow-up after initial registration, or cases rejected based on validation checks were excluded from the survival analysis. An easy guide to contents in subsequent chapters, especially tables and graphs describing data quality indices, survival statistics and online dynamic functions, is provided.

With the draft of the human genome and advances in technology, the approach toward mapping complex diseases and traits has changed. Human genetics has evolved into the study of the genome as a complex structure harbouring clues for multifaceted disease risk with the majority still unknown. The discovery of new candidate regions by genome-wide association studies (GWAS) has changed strategies for the study of genetic predisposition. More genome-wide, "agnostic" approaches, with increasing numbers of participants from high-quality epidemiological studies are for the first time replicating results in different settings. However, new-found regions (which become the new candidate "genes") require extensive follow-up and investigation of their functional significance. Understanding the true effect of genetic variability on the risk of complex diseases is paramount. The importance of designing high-quality studies to assess environmental contributions, as well as the interactions between genes and exposures, cannot be stressed enough. This chapter will address the basic issues of genetic variation, including population genetics, as well as analytical platforms and tools needed to investigate the contribution of genetics to human diseases and traits.

In a broad sense, molecular epidemiology is the axis that unites insights at the molecular level and understanding of disease at the population level. It is also a partnership between epidemiologists and laboratory scientists in which investigations are conducted using the principles of both disciplines. A key trait of molecular epidemiology is to evaluate and establish the relationship between a biomarker and important exogenous and endogenous exposures, susceptibility, or disease, providing understanding that can be used in future research and public health and clinical practice. When potential solutions or interventions are identified, molecular epidemiology is also useful in developing and conducting clinical and intervention trials. It can then contribute to the translation of biomedical research into practical public health and clinical applications by addressing the medical and population implications of molecular phenomena in terms of reducing risk of disease. This chapter summarizes the contributions and research endeavours of molecular epidemiology and how they link with public health initiatives and clinical practice.

The collection, processing and storage of biological samples occur in the larger context of organizations known as biological resource centres or biospecimen resources. Biological resource centres are service providers and repositories of living cells, as well as genomes of organisms, archived cells and tissues, and information relating to these materials. The US National Cancer Institute defines a biospecimen resource as a "... collection of human specimens and associated data for research purposes, the physical entity where the collection is stored, and all relevant processes and policies." The complexities involved in proper sample management policies and procedures are often underestimated. Prior to initiating a study that will involve the collection of biological samples, many decisions need to be made that will affect the quality of the samples and the outcome of the study. The appropriate sample type(s) needs to be chosen. The processing protocol that will result in samples of suitable quality for the intended laboratory analyses must be selected from among various possible protocols. Consideration must be given to the proper storage conditions to maintain sample quality until analyses are completed. All of these activities must be monitored and controlled by appropriate sample tracking and laboratory informatics systems. A comprehensive quality management system, with standard operating procedures and other appropriate controls, is necessary to assure that biological samples are of consistent quality and right for the intended analyses and study goals.

The Songkhla registry, besides being hospital-based, has population-based cancer registration data available since 1990. Cancer registration is done by active methods. The registry is contributing data on survival for 36 cancer sites or types registered during 1990-1999. Follow-up has been carried out by passive and active methods with median follow-up ranging from 3-71 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged between 52-100%; death certificate only (DCO) cases comprised 0-34%; 54-93% of total registered cases were included for survival analysis. Complete followup at five years ranged from 50-85% for different cancers. Five-year age-standardized relative survival rates of common cancers were cervix (59%), lung (7%), breast (59%), thyroid (86%), oesophagus (11%), liver (2%), nonmelanoma skin (75%), colon (45%) and oral cavity (33%). Five-year relative survival by age group did not reveal any pattern or trend and was fluctuating. A majority were diagnosed with regional spread of disease, and survival decreased with increasing clinical extent of disease.

The Khon Kaen cancer registry was established in 1984 as a hospital-based cancer registry, and population-based cancer registration started in 1988 with retrospective data collection from 1985. Cancer registration is done by passive and active methods. Data on survival for 13 cancer sites or types registered during 1993-1997 were reported. Follow-up was done by active methods, with median follow-up ranging between 8-32 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged between 54-100%; death certificates only (DCOs) comprised 0-5%; 85-97% of total registered cases were included for survival analysis. Five-year follow-up ranged from 40-83%. Five-year age-standardized relative survival rates for common cancers were cervix (58%), breast (61%), colon (39%), ovary (43%), non-Hodgkin lymphoma (42%) and rectum (43%). Five-year relative survival by age group portrayed an inverse relationship or was fluctuating. Five-year survival was the highest for localized disease, followed by the regional and distant metastasis categories. Trends in 5-year relative survival in 1993-1997 compared to 1985-1992 showed a marked increase for cancers of the rectum, breast, ovary, Hodgkin and non-Hodgkin lymphomas and decrease for cancers of the lip and larynx.